Sudan war: Life-saving cholera vaccination campaign begins in Darfur

The World Health Organization (WHO)'s Deputy Representative to the country Hala Khudari reported on Tuesday that the outbreak, which started in July 2024 in Kassala, has spread to all 18 states of the country.

More than 113,600 cases have been registered so far and over 3,000 deaths - a "concerning case fatality rate" of 2.7 per cent.

Speaking from Port Sudan, she said that the past year saw surges in White Nile and Khartoum among other states, resulting from the impact of the conflict and increased population movement. This critical situation has been compounded by severely limited basic services such as water, food and health, caused by ongoing heavy fighting between the Sudanese army and the paramilitary Rapid Support Forces.

Cholera is an acute intestinal infection that spreads through bacteria-contaminated food and water. According to WHO, it can kill within hours when not treated, and case fatality rates above one per cent indicate "serious gaps in case management and delayed access to care".

Conditions ripe for disease

The resurgence of cholera in Sudan has been fuelled by heavy rains and flooding, overcrowding and lack of access to clean water in displacement sites and within communities.

In the Darfur region, where cholera has been spreading since May, the number of cases continues to increase amid "severe access constraints" which are impeding the response, including inaccessible roads due to the rainy season, Ms. Khudari said. As of two days ago 12,739 cases and 358 deaths were reported in more than half of all the localities of the five Darfur states.

In certain localities in West Darfur, the case fatality rate has been as high as 11.8 per cent, she said.

Ms. Khudari explained that WHO and partners have been working to control the outbreak with a vaccination campaign in the worst-hit communities. It began last Sunday "after weeks of preparations to overcome access, transport and logistical challenges".

The campaign aims to protect 1.86 million people in six priority localities of the Darfurs.

The WHO representative said that the "biggest challenge" in launching the campaign was to "actually get the vaccines there". She described the difficulties in delivering the life-saving immunizations and supporting supplies via "long routes" to Nyala in South Darfur state earlier this month, amid ongoing security concerns.

El Fasher survivors

Preparations are ongoing to launch the campaign by the end of September in Tawila in North Darfur State, which hosts more than 575,000 internally displaced people, most of whom have fled from the besieged city of El Fasher.

The vaccines are being deployed in Sudan with the support of the UN Children's Fund (UNICEF), whose spokesperson Ricardo Pires raised the alarm over the severe risks of cholera for children.

Children under five have been "disproportionately affected", he told reporters, and so far at least 380 have died.

Access to life-saving treatment for cholera in Sudan is limited as the almost two-and-a-half-year-old violent conflict has devastated the health system.

The outbreak comes at a time when "more than 70 per cent of hospitals in conflict-affected areas are non-operational, with health centres being damaged or destroyed during the conflict, lacking supplies and even staff, as well as facilities being often used as shelter," Mr. Pires stressed.

The UNICEF spokesperson also underscored the impact of "relentless" attacks on the country's power and water infrastructure which have off cut millions of people including many children from safe and clean water, forcing families to collect water from unsafe and contaminated sources.